Donald Trump’s Health Care Dance

Do issues still matter to Republican voters, or are they so mad at the failed GOP establishment that they have forgotten what made them mad in the first place?

Donald Trump’s past flirtation with a nationalized government run health care system brings this question starkly into play. In his book, “The America We Deserve,” published in 2000, Trump wrote, “We must have universal healthcare. I’m a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses.”

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That was then.

As a candidate for the 2016 Republican nomination, Trump seemingly recanted his support for a single payer system in the Aug. 6, 2015 Fox News GOP presidential debate. “It could have worked in a different age, which is the age you’re talking about here. What I’d like to see is a private system without the artificial lines around every state.”

On Sept. 27, 2015 on “60 Minutes” Trump said, “Everybody’s got to be covered… I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now… They’re going to be taken care of. I would make a deal with existing hospitals to take care of people.”

At the Jan. 14, 2016 Fox Business debate, Trump added, “Obamacare, we’re going to repeal it and replace it.” But replace it with what?

Then, most recently, Trump raised questions again about where he really stands on the health care issue, when he said on ABC’s “This Week,” “I want people taken care of. I have a heart. I want people taken care of. If people have no money, we have to help people. But that doesn’t mean single payer. It means we have to help people. If somebody has no money and they’re lying in the middle of the street and they’re dying, I’m going to take care of that person.”

Maybe that’s not single payer, but how is that not still universal coverage? What’s more it is a false analogy as the pre-Obamacare state administered Medicaid would take care of that indigent person, and a repeal would merely lower the number of people eligible for the help.

Trump’s seeming teflon on issues like what to do about Obamacare really raises the question if Republican voters are so angry at the insider deal making that cut them out of the process, that they would rather opt for their own deal maker who rhetorically sounds more like Hillary Clinton on health care than Ronald Reagan?

The health care issue is particularly acute because Trump’s top opponent, Senator Ted Cruz, drew the ire of his colleagues when he forced them to fight President Obama over the funding of Obamacare, before the system became entrenched.

It was Cruz’s dynamic opposition that rallied the Republican base against the noxious, failed law, costing him friendships as he refused to play the game with one sixth of the economy on the line. Ironically, the same Senate Republicans who whined that Cruz’s Obamacare government shutdown would hurt the GOP’s chances for victory in 2014 still run political ads saying they are going to get rid of Obamacare today benefiting from the credibility Cruz’s fight provided.

Replacing Obamacare will be one of the major domestic problems that the new president will face in 2017 as the system continues to crash.

It will require leadership, knowledge, but most importantly it will require a strong vision for what health care should look like in America. Should it be one that emphasizes free markets and broad numbers of insurance products offered with each state being primarily responsible, or will it be a federal government driven top down system?

Former Republican candidates like Governor Bobby Jindal, a health care expert, even went so far as to publish a detailed treatment of how he would approach replacing Obamacare, which included block grants for states to determine for themselves how to spend Medicaid dollars, while his campaign foundered his policy paper is still out there.

Jindal understood that the Obamacare system has put down some roots, and tearing it out was not going to be an easy task that could be glibly done with the wave of a wand or a pronouncement from a podium. He understood that whatever health care system replaced Obamacare would set the tone for whether or not the federal government continued its expansion in scope and power. He understood that what we do about Obamacare is likely to be one of the most important domestic policy decisions that any president will make. So, he laid out his vision for what health care should look like in America.

Before any more votes are cast, GOP candidates should tell voters what their vision of what the nation’s health care system should look like. Being angry is not enough, passion without vision always leads to colossal mistakes. We need details. And that’s not too much to ask.

In 2012, the GOP nominated a candidate, Mitt Romney, who helped create the precursor to Obamacare as governor of Massachusetts, and then wondered why he didn’t have any credibility on their most important issue to drive people to the polls. The primary system failed to properly vet out a man whose own public record made him sound foolish when he spoke about repealing Obamacare.

Now GOP voters have the chance to get it right, and this is their last chance. Just as in the Bible where even the demons recognize Jesus, likewise even the left wants to get rid of Obamacare, it is just a matter of what system they put in place.

After all, even Democrat Socialists like Bernie Sanders agree that Obamacare needs to be repealed and replaced. The difference is that he wants to replace it with a federal government run single payer system which puts bureaucrats between patients and their doctors. An idea which Donald Trump endorsed in 2000 and to date has danced dangerously close to in his rhetorical bobbing and weaving on the issue.

GOP voters are angry and rightfully so, but issues need to matter too. When it comes to health care failure to learn at least the philosophical underpinnings of each candidates approach could lead to America getting a bad, bad deal.